Multivariable Cox regression with interaction terms showed that adding NLR or NPR to PCT did not provide additional prognostic value beyond PCT alone (PCT × NLR: HR = 1.00, 95% CI: 0.97-1.03, p = 0.854; PCT × NPR: HR = 0.97, 95% CI: 0.92-1.01, p = 0.121).<h4>Conclusion</h4>Neither NLR nor NPR alone, nor their combination with PCT, improved 28-day mortality prediction in this elderly sepsis cohort, suggesting that a single early measurement may be insufficient for sepsis prognostication. Here, NPTXR is linked to Sepsis.